TOWN OF LANCASTER

Application for Town Election Absentee Ballot

Absence, Religious Observance and Disability

I. New Hampshire law requires that you vote in person at the polling place for your town or ward unless you:

  1. Plan to be absent on the day of the election from the city, town or unincorporated place in which you are registered to vote.
  2. Cannot appear in public on Election Day because of observance of a religious commitment.
  3. Are unable to vote in person due to a disability.
  4. Cannot appear at any time during polling hours at your polling place because an employment obligation requires you to remain physically at work or to be in transit to or from work from the time the polls open until after the time the polls close.

RSA 657:1. Any person who votes or attempts to vote using an absentee ballot who is not entitled to vote by absentee ballot shall be guilty of a misdemeanor. RSA 657:24

II. I am requesting an absentee ballot for the following election:

______Annual Town Election (includes School District ballot)

III. Applicant’s Name

___________________________________________________________________

(Last) (First) (Middle) (Jr., Sr., II, III)

Applicant’s Voting Domicile (home address)________________________________

(Street)

___________________________________________________________________

(City/Town) (zip)

Mail the ballot to me at this address:

___________________________________________________________________

(Mailing Address)

___________________________________________________________________

(City/Town) (zip)

IV. I hereby declare that:

Turn over to complete the application

 

 

 

 

 

 

 

IV. I will be entitled to vote by absentee ballot at the election designated above because:

  • I plan to be absent on the day of the election from the city, town or unincorporated place where I am domiciled.
  • I cannot appear in public on election day because of observance of a religious commitment.
  • I am unable to vote in person due to a disability.
  • I cannot appear at any time during polling hours at my polling place because an employment obligation requires me to remain physically at work, or to be in transit or from work from the time the polls open until after the time the polls close.

 

VI. _____________________________________________

Applicant’s Signature

The absentee ballot forms you receive will require you to sign an affidavit confirming that you are entitled to vote by absentee ballot due to one of the reasons stated above. The moderator is required to compare the signature on the affidavit to your signature on this form. The absentee ballot will not be counted if the affidavit and this form do not appear to have been signed by the same person. RSA 659:50.